People with disabilities are 4 to 10 times more likely to become a victim of violence, abuse, or neglect than individuals without disabilities.1 While there is less concrete information about the victimization of individuals who have had a traumatic brain injury (TBI),2 the cognitive, physical, behavioral, and emotional impairments that occur after brain injury can leave you or your family member more vulnerable to abuse, mistreatment and neglect.

While most people understand what constitutes physical, sexual, and emotional abuse, the idea of mistreatment and neglect may be less clear. A caregiver who restrains or punishes an individual, restricts their access to food, water, or the bathroom, or consistently shows up late may be neglecting their responsibilities.

How to Recognize abuse or neglect3,4

Among adults, the following may be signs of abuse or neglect:

  • Unexplained bruises, broken bones, abrasions, and burns
  • Storied of how injuries were obtained does not make sense
  • Unexplained withdrawal from normal activities or friends
  • An anxious or depressed mood when the caregiver is present
  • Bruises around the breasts or genital area
  • Sudden changes in financial situations (possible sign of exploitation)
  • Bedsores, unattended medical needs, poor hygiene, and changes in weight
  • Caregiver belittles, threatens, and blames the individual regularly and describes them negatively
  • Caregiver demands an unreasonable level of performance
  • Caregiver limits contact with others

In addition to the above symptoms, children may show the following signs:

  • A sense of guilt, shame or confusion about the abuse
  • A fear of the caregiver
  • Changes in school performance
  • Lack of supervision
  • Change in behavior (aggression, anger, hostility, or hyperactivity)
  • Frequent absences from school or reluctance to go home after school
  • Sexual behavior or knowledge that’s inappropriate for the child’s age
  • Loss of self-confidence or self-esteem
  • Poor growth or weight gain

What to do when you have concerns

There are several steps you can take if you are concerned that you or a loved one is being mistreated or abused.

  • Seek assistance from his or her physician, mental health professional, or case manager
  • Call the police or 911
  • Contact Adult Protective Services or Child Protective Services
  • Alert school officials
  • Seek support from organizations such as the Brain Injury Association of America, National Disability Rights Network, National Domestic Violence Hotline.5
  • Contact a long-term care ombudsman
  • Contact directors of the facility where you or your family is residing or receiving services


  1. Petersilia, JR. Crime victims with developmental disabilities: a review essay. Criminal Justice & Behavior 2001; 28(6):655–94.
  2. Marge K. Introduction to violence and disability. In: Marge K, editor. A call to action: Ending crimes of violence against children and adults with disabilities, a report to the nation. Syracuse: State University of New York, Upstate Medical University; 2003. p. 1-16.
  3. National Center on Elder Abuse: Administration on Aging.  Frequently Asked Questions.  Retrieved 9/9/14.
  4. Child Abuse Symptoms. Mayo Clinic Website.  Published 10/23/12.  Accessed 9/9/14.
  5. Victimization of Persons with Traumatic Brain Injury or Other Disabilities: A Fact Sheet for Professionals. Centers for Disease Control and Prevention.  Accessed 9/9/14.